扁鹊曰∶夫相死脉之气，如群鸟之聚，一马之驭系，水交驰之状，如悬石之落。出筋之上，藏筋之下，坚关之里，
不在荣卫，伺候交射，不可知也。脉病患不病，脉来如屋漏、雀啄者，死（屋漏者，其来既绝而止，时时复起，而不相
连属也。雀啄者，脉来甚数而疾，绝止复顿来也）。又经言∶得病七八日，脉如屋漏、雀啄者，死（脉弹人手如黍米也）
脉来如弹石，去如解索者，死。（弹石者，辟辟急也。解索者，动数而随散乱，无复次绪也）脉困，病患脉如虾之游，如
鱼之翔者，死。（虾游者，苒苒而起，寻复退没，不知所在，久乃复起，起辄迟而没去速者是也。鱼翔者，似鱼不行，而
但掉尾动，头身摇而久住者是也）脉如悬薄卷索者，死。脉如转豆者，死。脉如偃刀者，死。脉涌涌不去者，死。脉忽
去忽来，暂止复来者，死。脉中侈者，死。脉分绝者，死。（上下分散也）脉有表无里者，死。经名曰结，去即死。何谓
结？脉在指下如麻子动摇，属肾，名曰结，去死近也。脉五来一止，不复增减者，死。经名曰代。何谓代？脉五来一止
也。脉七来是人一息，半时不复增减，亦名曰代，正死不疑。
经言∶病或有死，或有不治自愈，或有连年月而不已。其死生存亡，可切脉而知之耶？然∶可具知也。设病者若闭
目不欲见人者，脉当得肝脉，弦急而长，反得肺脉浮短而涩者，死也。病若开目而渴，心下牢者，脉当得紧实而数，反
得沉滑而微者，死。病若吐血，复鼽衄者，脉当得沉细，而反浮大牢者，死。病若谵言妄语，身当有热，脉当洪大，而
反手足四逆，脉反沉细微者，死。病若大腹而泄，脉当微细而涩，反得紧大而滑者，死。此之谓也。
经言∶形脉与病相反者，死。奈何？然∶病若头痛目痛，脉反短涩者，死。病若腹痛，脉反浮大而长者，死。
病若腹满而喘，脉反滑利而沉者，死。
病若四肢厥逆，脉反浮大而短者，死。
病若耳聋，脉反浮大而涩者，死（《千金翼》云∶脉大者生，沉迟细者难治）
病若目KT KT ，脉反大而缓者，死。左有病而右痛，右有病而左痛，下有病而上痛，上有病而下痛，此为逆，
逆者死，不可治。
脉来沉之绝濡，浮之不止，推手者，半月死。（一作半日）
脉来微细而绝者，人病当死。
人病脉不病者，生；脉病患不病者，死。
人病尸厥，呼之不应，脉绝者，死。脉当大反小者，死。
肥人脉细小，如丝欲绝者，死。
羸人得躁脉者，死。
人身涩而脉来往滑者，死。
人身滑而脉来往涩者，死。
人身小而脉来往大者，死。
人身短而脉来往长者，死。
人身长而脉来往短者，死。
人身大而脉来往小者，死。
尺脉不应寸，时如驰，半日死。（《千金》云∶尺脉上应寸口，太迟者，半日死）
肝脾俱至，则谷不化。肝多即死。
肺肝俱至，则痈疽，四肢重。肺多即死。
心肺俱至，则痹，消渴，懈怠。心多即死。
肾心俱至，则难以言，九窍不通，四肢不举。肾多即死。
脾肾俱至，则五脏败坏。脾多即死。
肝心俱至，则热甚 ，汗不出，妄见邪。
肝肾俱至，则疝瘕，少腹痛，妇人月使不来。
肝满、肾满、肺满皆实，则为肿。肺之雍，喘而两 满。肝雍，两 满，卧则惊，不得小便。肾雍，脚下至少腹满，
HT有大小，髀 大跛，易偏枯。
心脉满大，痫 筋挛。
肝脉小急，痫 筋挛。
肝脉骛暴，有所惊骇，脉不至，若喑，不治自已。
肾脉小急，肝脉小急，心脉小急，不鼓皆为瘕。
肾肝并沉，为石水；并浮，为风水；并虚，为死；并小弦，欲惊。
肾脉大急沉，肝脉大急沉，皆为疝。
心脉搏滑急为心疝，肺脉沉搏为肺疝。
脾脉外鼓，沉为肠 ，久自已。
肝脉小缓为肠 ，易治。
肾脉小搏沉，为肠 下血，温身热者死。心肝 ，亦下血。二脏同病者可治，其脉小沉涩者为肠 ，其身热者死，
热见七日死。
胃脉沉鼓涩，胃外鼓大，心脉小紧急，皆膈偏枯，男子发左，女子发右，不喑舌转，可治，三十日起。其顺者喑，
三岁起。年不满二十者，三岁死。
脉至而搏，血衄身有热者死。脉来如悬钩，浮，为热。
脉至如喘，名曰气厥。气厥者，不知与人言。（《素问》《甲乙》作暴厥）
脉至如数，使人暴惊，三四日自已。
脉至浮合，浮合如数，一息十至、十至以上，是为经气予不足也，微见，九十日死。
脉至如火新然，是心精之予夺也，草干而死。
脉至如散叶，是肝气予虚也，木叶落而死。（木叶落作枣华）
脉至如省客，省客者，脉塞而鼓，是肾气予不足也，悬去枣华而死。
脉至如泥丸，是胃精予不足也，榆荚落而死。（《素问》荚作叶）
脉至如横格，是胆气予不足也，禾熟而死。
脉至如弦缕，是胞精予不足也，病善言，下霜而死；不言，可治。
脉至如交漆，交漆者，左右旁至也，微见四十日死。（《甲乙》作交棘）。
脉至如涌泉，浮鼓肌中，是大肠气予不足也，少气，味韭英而死。脉至如委土（《素问》作颓土）之状，按之不得，
是肌气予不足也，五色先见黑，白垒（一作 ）发死。脉至如悬雍，悬雍者，浮揣切之益大，是十二俞之予不足也，水
凝而死。
脉至如偃刀，偃刀者，浮之小急也，按之坚大急，五脏菀熟，寒热独并于肾也，如此其人不得坐，立春而死。脉至
如丸滑不直手，不直手者，按之不可得也，是大肠气予不足也，枣叶生而死。脉至如舂者，令人善恐，不欲坐卧，行立
常听，是小肠气予不足也，季秋而死。
问曰∶尝以春二月中，脉一病患，其脉反沉。师记言∶到秋当死。其病反愈，到七月复病，因往脉之，其脉续沉。
复记言∶至冬死。
问曰∶二月中得沉脉，何以故处之至秋死也？师曰∶二月之时，其脉自当濡弱而弦，得沉脉，到秋自沉，脉见浮即
死，故知到秋当死也。七月之时，脉复得沉，何以处之至冬当死？
师曰∶沉脉属肾，真脏脉也，非时妄见。经言∶王相囚死。冬脉本王脉，不再见，故知至冬当死也。然后至冬复病，
王以冬至日死，故知为谛。华佗效此。
Bi Que said: The qi of the pulse indicating death is like a gathering of birds, or like the reins tied when driving a single horse, resembling the state of intersecting rushing water, or like a suspended heavy stone falling. This pulse qi appears above the tendons, below the tendons, inside the firm gate (Ji Guan), not within the regular circulation of Ying (Nutrient) and Wei (Defensive) qi. They cross-shoot each other and are unpredictable.
If the patient's pulse is abnormal while the body seems healthy, and the pulse comes like a leaking roof (Wu Lou: the pulse arrives, stops, occasionally rises again, but does not connect continuously; Que Zhuo: the pulse comes very rapidly and swiftly, stopping abruptly then suddenly returning), or like a sparrow pecking, it indicates death. It is also stated in the classics: If after seven or eight days of illness, the pulse resembles a leaking roof or sparrow pecking, it indicates death. (The pulse feels like millet grains striking the hand). If the pulse comes like throwing stones (Tan Shi: rapid and hard) and leaves like an untying rope (Jie Suo: moving rapidly and then scattering chaotically without order), it indicates death. If the pulse is exhausted, and the patient's pulse resembles a shrimp swimming (Xia You: rising faintly then retreating and disappearing, unknown whereabouts, rising again after a long time, slowly appearing and quickly vanishing) or a fish gliding (Yu Xiang: seeming not to move but only wagging its tail, head and body swaying while staying in place for a long time), it indicates death. A pulse like a hanging thin rolled cord indicates death. A pulse like rolling beans indicates death. A pulse like an inverted knife indicates death. A surging pulse that does not recede indicates death. A pulse that goes and comes intermittently, pausing briefly before returning, indicates death. A full pulse in the middle indicates death. A divided and severed pulse indicates death (scattered up and down). A pulse with exterior but no interior indicates death. The classics call this "Jie" (Knot); once it departs, death follows. What is Jie? When the pulse under the fingers moves like hemp seeds, belonging to the Kidney, it is named Jie, meaning death is near. A pulse that beats five times then pauses, without further increase or decrease, indicates death. The classics call this "Dai" (Intermittent). What is Dai? A pulse that beats five times then pauses. A pulse that beats seven times per respiration, remaining unchanged for half an hour, is also called Dai, undoubtedly fatal.
The classics state: Some diseases lead to death, some heal spontaneously without treatment, and some persist for years. Can one know life and death through palpation? Yes, it can be fully known. Suppose a patient closes their eyes and does not wish to see people; the pulse should correspond to the Liver pulse, string-taut, rapid, and long. If instead, the Lung pulse (floating, short, and choppy) is obtained, it indicates death. If a patient opens their eyes, feels thirsty, and has a firm mass in the epigastrium, the pulse should be tight, solid, and rapid. If instead, a deep, slippery, and weak pulse is obtained, it indicates death. If a patient vomits blood and suffers from epistaxis, the pulse should be deep and fine. If instead, a floating, large, and firm pulse is obtained, it indicates death. If a patient speaks deliriously and妄语 (nonsense), the body should be hot, and the pulse should be洪大 (surging and large). If instead, the four limbs are cold and the pulse is deep, fine, and weak, it indicates death. If a patient has abdominal distension and diarrhea, the pulse should be micro-fine and choppy. If instead, a tight, large, and slippery pulse is obtained, it indicates death. This is referred to as pulse-disease contradiction.
The classics state: When the physical condition and pulse contradict each other, it indicates death. How so? If a patient has headache and eye pain, but the pulse is short and choppy, it indicates death. If a patient has abdominal pain, but the pulse is floating, large, and long, it indicates death. If a patient has abdominal fullness and wheezing, but the pulse is slippery, smooth, and deep, it indicates death. If a patient has cold extremities (Jue Ni), but the pulse is floating, large, and short, it indicates death. If a patient has deafness, but the pulse is floating, large, and choppy, it indicates death (*Qian Jin Yi Fang* states: Large pulse implies survival; deep, slow, and fine pulse implies difficult treatment). If a patient has blurred vision (Ku Ku), but the pulse is large and slow, it indicates death. Pain on the left side due to disease on the right, pain on the right due to disease on the left, pain above due to disease below, pain below due to disease above—this is called "Ni" (Reverse). Reverse cases die and are incurable.
A pulse that is absent and soft upon deep pressure, but unremitting upon superficial pressure, with pushing movements in the hand, indicates death in half a month (or half a day). A pulse that is micro-fine and severed indicates the patient will die.
When the person is ill but the pulse is normal, there is life; when the pulse is ill but the person seems healthy, there is death.
A patient suffering from Shi Jue (Corpse Faint) who does not respond to calls and has a severed pulse will die. A pulse that should be large but is small indicates death.
In obese individuals, a pulse that is fine and thread-like, about to sever, indicates death.
In emaciated individuals, a restless pulse indicates death.
When the body is rough/astringent but the pulse is slippery, it indicates death.
When the body is slippery but the pulse is astringent/choppy, it indicates death.
When the body is small but the pulse is large, it indicates death.
When the body is short but the pulse is long, it indicates death.
When the body is long but the pulse is short, it indicates death.
When the body is large but the pulse is small, it indicates death.
If the Chi (Cun Cun) pulse does not correspond to the Cun (Inch) pulse, and is sometimes rapid like a galloping horse, death occurs in half a day. (*Qian Jin Fang* states: If the Chi pulse corresponds to the Cun Kou and is too slow, death occurs in half a day).
If both Liver and Spleen pulses are present, food is not digested. Excess Liver pulse leads to death.
If both Lung and Liver pulses are present, carbuncles and sores arise, and the four limbs feel heavy. Excess Lung pulse leads to death.
If both Heart and Lung pulses are present, Bi syndrome (obstruction), Xiao Ke (wasting-thirst), and lassitude occur. Excess Heart pulse leads to death.
If both Kidney and Heart pulses are present, speech is difficult, the nine orifices are blocked, and the four limbs cannot move. Excess Kidney pulse leads to death.
If both Spleen and Kidney pulses are present, the five zang organs deteriorate. Excess Spleen pulse leads to death.
If both Liver and Heart pulses are present, heat is severe, sweat does not come out, and hallucinations of evil spirits occur.
If both Liver and Kidney pulses are present, Shan Jia (hernia masses) occur, lower abdominal pain arises, and menstruation ceases in women.
Fullness in the Liver, Kidney, and Lung presenting as excess leads to swelling. Lung congestion causes wheezing and bilateral hypochondriac fullness. Liver congestion causes bilateral hypochondriac fullness, fright when lying down, and inability to urinate. Kidney congestion causes fullness from the sole of the foot to the lower abdomen, asymmetry of the thighs, limping, and predisposition to hemiplegia.
A full and large Heart pulse leads to epilepsy and tendon spasms.
A small and urgent Liver pulse leads to epilepsy and tendon spasms.
A chaotic and violent Liver pulse, caused by fright, results in no pulse or aphonia; it heals spontaneously without treatment.
Small and urgent pulses in the Kidney, Liver, and Heart, which do not beat vigorously, indicate Jia (masses).
Deep pulses in both Kidney and Liver indicate Shi Shui (Stone Water); floating pulses indicate Feng Shui (Wind Water); empty pulses indicate death; small and stringy pulses indicate impending fright.
Large, urgent, and deep pulses in both Kidney and Liver indicate Shan (hernia).
A slippery, urgent, and beating Heart pulse indicates Xin Shan (Heart Hernia); a deep and beating Lung pulse indicates Fei Shan (Lung Hernia).
An outwardly bulging Spleen pulse that is deep indicates Chang Tan (intestinal tumor), which heals itself over time.
A small and slow Liver pulse indicates Chang Tan, which is easy to treat.
A small, beating, and deep Kidney pulse indicates Chang Tan with bloody stool; if accompanied by warm body heat, it indicates death. Simultaneous involvement of Heart and Liver also causes bloody stool. Treatable if both organs are involved; however, if the pulse is small, deep, and choppy with body heat, it indicates death, with death occurring within seven days of fever appearance.
A deep, bulging, and choppy Stomach pulse, an outwardly large Stomach pulse, and a small, urgent Heart pulse all indicate Ge Pian Gu (diaphragmatic hemiplegia). In men, it manifests on the left; in women, on the right. If there is no aphonia and the tongue turns freely, it is treatable, with recovery in thirty days. If aphonic, recovery takes three years. For those under twenty, death occurs in three years.
A pulsating pulse with epistaxis and body heat indicates death. A pulse coming like a hanging hook, floating, indicates heat.
A pulse coming like panting is named Qi Jue (Qi Syncope). Those with Qi Jue cannot speak with others. (*Su Wen* and *Jia Yi Jing* refer to this as Bao Jue/Sudden Syncope).
A rapid pulse causes sudden fright and heals spontaneously in three to four days.
A floating-combined pulse (Fu He), resembling a rapid pulse, with ten beats or more per respiration, indicates insufficiency of Jing Qi. If slightly visible, death occurs in ninety days.
A pulse burning like fresh fire indicates the deprivation of Heart Essence; death occurs when grass dries.
A pulse like scattered leaves indicates deficiency of Liver Qi; death occurs when tree leaves fall. (Some texts say "when jujube flowers bloom").
A pulse like a visiting official (Sheng Ke), where the pulse is blocked yet bulging, indicates insufficiency of Kidney Qi; death occurs when jujube flowers bloom.
A pulse like a clay pill indicates insufficiency of Stomach Essence; death occurs when elm pods fall. (*Su Wen* reads "leaves" instead of "pods").
A pulse like a horizontal grid indicates insufficiency of Gallbladder Qi; death occurs when grain ripens.
A pulse like a silk thread indicates insufficiency of Bao (Uterus/Bladder) Essence. If the patient talks excessively, death occurs at frost; if silent, it is treatable.
A pulse like crossing lacquer (Jiao Qi), arriving from both sides laterally, indicates death in forty days if slightly visible. (*Jia Yi Jing* reads "crossing thorns").
A pulse like a gushing spring, floating and beating in the muscles, indicates insufficiency of Large Intestine Qi. With shortness of breath, death occurs after consuming leek greens. A pulse like collapsed earth, indistinguishable upon pressure, indicates insufficiency of Muscle Qi. If black color appears first among the five complexions, death occurs with white pustules. A pulse like the uvula, becoming larger upon superficial tapping and pressing, indicates insufficiency of the Twelve Shu points; death occurs when water freezes.
A pulse like an inverted knife, small and urgent superficially, firm, large, and urgent deeply, indicates accumulation and heat in the five Zang organs, with cold and heat combining exclusively in the Kidney. Such patients cannot sit upright and die at the beginning of Spring. A pulse like a slippery ball that slips from the fingers indicates insufficiency of Large Intestine Qi; death occurs when jujube leaves grow. A pounding pulse makes people prone to fear, unwilling to sit or lie down, often listening while walking or standing, indicating insufficiency of Small Intestine Qi; death occurs in late autumn.
Question: Once, in mid-spring (second lunar month), a patient had a pulse that was contrary, appearing deep. The master recorded: "Death will occur in autumn." The illness healed, but returned in July. Upon palpation, the pulse remained deep. The master recorded: "Death will occur in winter."
Question: Why does a deep pulse in February predict death in autumn? Master said: In February, the pulse should naturally be soft-weak and stringy. Obtaining a deep pulse means it will deepen in autumn. If the pulse becomes floating, death ensues. Thus, we know death will occur in autumn. In July, obtaining a deep pulse again predicts death in winter?
Master said: Deep pulse belongs to the Kidney and represents the True Organ Pulse (Zhen Zang Mai), appearing out of season. The classics state: Wang (Prosperous), Xiang (Strong), Qiu (Imprisoned), Si (Dead). Winter pulse is the King pulse; seeing it again implies death. Thus, we know death will occur in winter. Then, in winter, the illness returns, and the King pulse causes death on the Winter Solstice day. Thus, we know this is accurate. Hua Tuo followed this example.